The Process of Change

The Transtheoretical Model of Change was developed in the late 1970s by J. Prochaska, J. Norcross and C. DiClemente. This theory of the human change process is important in several ways, but probably most importantly, it offers a framework for people and those helping to approach each other with a common language and understanding of what is happening and what might be helpful. This theory of change has been embraced by many professionals in the substance abuse field. According to this theory, there are 6 stages of change that can be applied to any change. The stages are:

According to the theory, each of these stages is characterized by certain, thoughts and feelings by the person seeking to change. In addition, there is a set of “stage matched” interventions that are considered most appropriate to be implemented by the professional helper.

The table below gives a handy guide to the characteristics and the suggested interventions.

Stage/Characteristics___________________________________________________________________________________________Precontemplation: Person is not ready to change, may be unaware there is a problem or need to do something differently.___________________________________________________________________________________________Contemplation: Person is getting ready to change, may begin to admit or recognize that their behaviors are not helping them.___________________________________________________________________________________________Preparation: Person is ready to change, may begin planning for change or taking the initial first steps toward change. ___________________________________________________________________________________________ Action: Person is “doing” change; behaviors are different than they were. ___________________________________________________________________________________________ Maintenance: Person has completed change, able to sustain it.___________________________________________________________________________________________ Termination: Person has a new self concept, can’t see themselves doing the old behavior. ___________________________________________________________________________________________

Intervention

Raising awareness by education, gentle confrontation pointing out the effects of the problem behaviors.

Attempt to resolve ambivalence, encouraging and exposing to others who have made similar changes, build confidence.

Offer support, put a support system in place, reward small changes. Offer alternative activities, strengthen support system.

Develop a plan to prevent previous behavior from recurring, continue all above. Remain connected; allowing the person to know that if they notice concerns, they can take action without complete relapse.

Examples of each stage and corresponding intervention:

Stage/Characteristics___________________________________________________________________________________________Precontemplation: Person using alcohol on a daily basis, missing work, fighting with family members. Feels that everyone else is the problem. ___________________________________________________________________________________________ Contemplation: Same person begins to understand that his boss needs him to be at work consistently. His wife needs him to be available to assist with household activities. __________________________________________________________________________________________ Preparation: Same person begins to imagine what life without alcohol use could be. He begins to imagine the steps he could take to stop use. He may even talk to a treatment center and find out what his options are. May set a date to stop using. ___________________________________________________________________________________________Action: Same person takes the step of making a change. He may clear alcohol out of his home. He may change his normal activities so that he is not exposed to alcohol. ___________________________________________________________________________________________Maintenance: Person has stopped using alcohol and has been able to maintain it, therefore, knows what it takes to be successful. ___________________________________________________________________________________________ Termination: A person sees themselves as a non alcohol user.

Questions or comments? Email me at allison@allisonvelez.com

Intervention

Provide information about the biological, social and psychological effects of excessive alcohol use. Begin to introduce education about the process of stopping alcohol use, how it might be done. Share information about people who have been successful.

Encourage and provide information for disrupting the current self concept. Praise observed movement in the process, no matter how small.

Encourage to participate in other distracting activities. Praise and encourage. This is the time to identify risky people, places, things and emotions to be on guard for.

Assist to develop a relapse prevention plan which serves as a “life map” which should remain a priority for the person.

Clearly identify yourself as a willing support for any trouble down the road.